Sources:

Reproduced with permission from http://www.apa.org/pi/families/resources/child-sexual-abuse.aspx. Copyright (c) by the American Psychological Association. No further reproduction or distribution is permitted without written permission from the American Psychological Association.

What steps can parents/caregivers take to prevent and minimize risk for sexual abuse?

Teach your children:

Basic sexual education- a health professional can provide basic sexual education to your children if you feel uncomfortable doing so
That sexual advances from adults are wrong
To communicate openly- they should feel free to ask questions and talk about their experiences. Make it clear that they should feel free to report abuse to you or any other trusted adult. If you're concerned about possible sexual abuse, ask questions
The difference between good secrets (those that are not kept secret for long) and bad secrets (those that must stay secret forever)
The difference between "okay" and "not okay" touches
Accurate names for their private parts and how to take care of them (i.e., bathing, wiping after bathroom use) so they don't have to rely on adults or older children for help
That adults and older children never need help with their own private parts
That they can make decisions about their own bodies and say "no" when they do not want to be touched or do not want to touch others (even refusing to give hugs

Make sure that you know your child's friends and their families. If you feel uneasy about leaving your child with someone, don't do it.

What should parents/caregivers do if they suspect abuse?

Give the child a safe environment in which to talk to you or another trusted adult
Encourage the child to talk about the abuse, but be careful to not suggest events that may not have occurred
Guard against displaying emotions that would influence the child's telling of the information. Listen, stay calm, and remain supportive of the child with words and gestures.
Reassure the child that he or she did nothing wrong
Seek assistance for the child from a psychologist or other licensed mental health provider
Arrange for a medical examination for the child. Select a medical provider who has experience in examining children and identifying sexual and physical trauma. It may be necessary to explain to the child the difference between a medical examination and the abuse incident.
Many states require that individuals who know or suspect that a child has been sexually abused must report the abuse to local law enforcement or child protection officials
In all 50 states, medical personnel, mental health professionals, teachers, and law enforcement personnel are required by law to report suspected abuse.

Ask for help- There are a number of organizations focused on providing assistance to families dealing with child abuse

American Professional Society on the Abuse of Children (http://www.apsac.org/) (312) 554-0166
National Center for Missing and Exploited Children (http://www.missingkids.com/) 24 hour hotline: 1-800-THE-LOST
Child Help USA (http://www.childhelpusa.org/) 1-800-4-A-CHILD
Prevent Child Abuse America (http://www.preventchildabuse.org/) 1-800-CHILDREN
Child Welfare Information Gateway (http://www.childwelfare.gov/) 1-800-394-3366

What treatments are available for children and adolescents who have been sexually abused?

There are a number of empirically validated treatments for children who have been sexually abused:

Individual therapy
Family therapy
Group therapy
Trauma-focused cognitive behavioral therapy
Child-centered therapy

There is no "one size fits all" treatment for sexual abuse. Therapists may take a range of approaches to treatment depending on the individual characteristics of the child and the length of treatment.

Recovery is possible- children can be very resilient and with a combination of effective treatment and support from parents/caregivers, they do recover from abuse.

For more information on treatment of child sexual abuse, please visit the National Child Traumatic Stress Network (http://www.nctsn.org/)

What are the effects of sexual abuse?

Not all sexually abused children exhibit symptoms (some estimate up to 40% of children are asymptomatic) however others experience serious and long-standing consequences.

Child sexual abuse can result in both short-term and long-term harm, including mental health problems that extend into adulthood.

Sexual abuse can affect psychological, emotional, physical, and social domains of the child's life, including risk for:

Depression
Guilt
Fear
Post-traumatic stress disorder (PTSD)
Dissociative and anxiety disorders
Eating disorders
Poor self-esteem
Somatization, I.e., the expression of distress in physical symptoms
Chronic pain

Behavioral problems can include:

Sexualized behavior- which brings elevated risk for pregnancy and sexually transmitted infections
School/learning problems
Substance abuse
Destructive behavior
Sexual dysfunction in adulthood
Criminality in adulthood
Suicide

What are the warning signs of sexual abuse?

Consider the possibility of sexual abuse when the child exhibits:

An increase in nightmares and/or other sleeping difficulties
Angry outbursts
Anxiety
Depression
Difficulty walking or sitting
Withdrawn behavior
Pregnancy or contraction of a venereal disease, particularly under age 14
Propensity to run away
Refusal to change for gym or to participate in physical activities
Regressive behaviors depending on their age (e.g., return to thumb-sucking or bed-wetting)
Reluctance to be left alone with a particular person or people
Sexual knowledge, language, and/or behaviors that are unusual and inappropriate for their age

Take it very seriously when a child reports sexual abuse by a parent or another adult caregiver.

Consider the possibility of sexual abuse when the parent or other adult caregiver:

Is unduly protective of the child or severely limits the child's contact with other children, especially those of the opposite sex
Is secretive and isolated
Describes marital difficulties involving sexual relations or family power struggles

What are the risk and protective factors?

Research is still evolving around what risk factors presage child sexual abuse due to the difficulty involved in getting data. However, some general characteristics have been identified:

AGE

0-3 y/o: 10% of victims
4-7 y/o: 28.4% of victims
8-11 y/o: 25% of victims
12 and older: 35.9% of victims

Gender

Girls tend to be at greater risk of sexual victimization than boys.
However, boys are more likely to be victimized by a perpetrator outside the family than girls.

Disability

Children with disabilities are at elevated risk of abuse, particularly, if the disability impairs their perceived credibility, e.g., blindness, deafness, and mental retardation.

Prior history of victimization

Those with a prior history of sexual victimization are extremely likely to be revictimized. Some research estimates an increased risk of over 1000%.

Family characteristics

Absence of on or both parents is a risk factor

--some research found that children living with only one biological parent at twice the risk of sexual victimization.

--children living without both biological parents were at three times the risk of sexual victimization

Older children from father-only families were also at increased risk of sexual victimization compared to other children.
Presence of a stepfather in the home doubled the risk of sexual victimization for girls.

Parental characteristics associated with increased risk

Researchers have found that parents with a history of childhood sexual victimization are at an estimated risk 10 times greater for having a sexually abused child.
multiple caretakers for the child
Caretaker or parent who has multiple sexual partners
Drug and/or alcohol abuse
Stress associated with poverty
Social isolation and family secrecy
Child with poor self-esteem or other vulnerable state
History of abuse among other family members (e.g., siblings, cousins)
Unsatisfactory marriage or intimate partner violence for the mother

How prevalent is child sexual abuse?

Some CDC research has estimated that approximately 1 in 6 boys and 1 in 4 girls are sexually abused before the age of 18.

Other governmental research has estimated that approximately 300,000 children are abused every year in the United States.

However, accurate statistics on the prevalence of sexual abuse of children and adolescents are difficult to collect because it is vastly underreported and there are differing definitions of what constitutes sexual abuse.

Boys (and later, men) tend not to report their victimization, which may affect statistics. Some men even feel societal pressure to be proud of early sexual activity regardless of whether it was unwanted.

Boys are more likely than girls to be abused outside the family.

Most mental health and child protection professionals agree that child sexual abuse is not uncommon and is a serious problem in the United States.

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Resources

These are available resources for help.

We at Peaceful Hearts want you to always know that you are not alone. In the case of an emergency, call 911.

National Child Abuse Hotline
1.800.422.4453 
www.childhelp.org

National Domestic Violence Hotline
1.800.799.7233 
www.ndvh.org

Rape, Abuse & Incest National Network
1.800.656.4673
 www.rainn.org

National Teen Dating Abuse Helpline
1.866.331.9474 
www.loveisrespect.org

National Suicide Prevention Lifeline1.800.273.8255 www.suicidepreventionlifeline.org

Educate Yourself

Child Sexual Abuse Facts

For Parents, Teachers, and Other Caregivers

What is child sexual abuse?

It is very important not to taboo the topic of the "body" and to discuss personal boundaries with children, not to use euphemisms that blur the boundaries in the perception of one's body and its special parts. Learn more about how to properly communicate with children (what vocabulary and approaches to use) from a psychologist, as well as refer to useful literature and BestWritingService.com

Child sexual abuse is any interaction between a child and an adult (or another child) in which the child is used for the sexual stimulation of the perpetrator or an observer. A central characteristic of any abuse is domination of the child by the perpetrator through deception, force, or coercion into sexual activity. Children, due to their age, cannot give meaningful consent to sexual activity. You can read our article "Navigating the Psychology of Healing from Child Sexual Abuse" to better understand the main points.

Child sexual abuse includes touching and non touching behaviors:

Sexual kissing
inappropriate touching or fondling of the child's genitals, breasts, or buttocks
masturbation
oral-genital contact
sexual or digital (with fingers) penetration
pornography (forcing a child to view or use of the child in)
child prostitution
exposure or "flashing" of body parts to the child
voyeurism (ogling of the child's body)
verbal pressure for sex

Who are the victims of child sexual abuse?

Children of all ages, races, ethnicities, cultures, and economic backgrounds are vulnerable to sexual abuse. Child sexual abuse occurs in rural, urban, and suburban areas. It affects both girls and boys in all kinds of neighborhoods and communities, and in countries around the world.

Who are the perpetrators of child sexual abuse?

Most children are abused by someone they know and trust. An estimated 60% of perpetrators of sexual abuse are known to the child but are not family members, e.g., family, friends, babysitters, childcare providers, neighbors. About 30% of perpetrators are family members, e.g., fathers, mothers, brothers, uncles, aunts, cousins. Just 10% of perpetrators are strangers to the child. In most cases, the perpetrator is male regardless of whether the victim is a boy or girl. Some perpetrators are female-- it is estimated that women are the abusers in about 14% of cases reported among boys and 6% of cases reported among girls. Child pornographers and other abusers who are strangers may make contact with children via the Internet. Not all perpetrators are adults- an estimated 23% of reported cases of child sexual abuse are perpetrated by individuals under the age of 18.

Other common characteristics of perpetrators include:

a history of abuse (either physical or sexual)
alcohol or drug abuse

little satisfaction with sexual relationships with adults
lack of control over their emotions
mental illness in some cases
Although many children who have experienced sexual abuse show behavioral and emotional changes, many others do not. It is therefore critical to focus not only on detection, but on prevention and communication—by teaching children about body safety and healthy body boundaries, and by encouraging open communication.